For women’s rights groups who saw health reform as a chance to advance reproductive justice–including equity of access for poor women to all legal reproductive and sexual health services including abortion care–the past few months have been a serious disappointment. 

Disorganization and lack of clear leadership from the White House and Congress has left the Democrats once again ceding the conversation and the political territory to the far right.  Now, even in a compromise in which no federal funding for legal abortion services for women will be allowed, the President has been persistently reinforcing, if only rhetorically, the barriers poor women face to care, and to exercising their basic human rights to whether, when and with whom to have children.

The Center for Reproductive Rights (CRR) is one group that has openly expressed disappointment in the process and in the President’s comments on abortion funding in his speech Wednesday to both Houses of Congress.

Nancy Northrup, the president of the Center, called for "more forthright dialogue and vocal leadership on women’s health needs in the healthcare reform debate, particularly on the issue of access to abortion.

“It is lamentable that during a major speech on healthcare reform, the President chose to reinforce a longstanding barrier to women’s ability to obtain abortion. For years, the federal government has prohibited federal funds from being used to pay for abortion except under extremely narrow circumstances—even when a woman’s health is jeopardized by her pregnancy.

The effect has been millions of women, including those living below the poverty line, military personnel and their dependents, women served by the Indian Health Service, Peace Corps volunteers, and federal employees and their dependents who rely solely on these programs for their medical care are deprived of their right to safe, legal abortion."

But, as Northrup underscored, "Reproductive health, including decisions about whether or not to have children, cut to the core of a woman’s daily reality as well as her well-being. The fact that the President can set out to have a comprehensive discussion of healthcare needs, but end up relegating an essential medical service, only used by women, to an outlier status, is disappointing to say the least.  This was a missed opportunity to re-examine the meaning of access to a full range of choices in healthcare for women."

CRR’s statement on the speech underscores that abortion is the most common surgical procedure in the United States and one in three women will have one in their lifetimes.

"Private insurers appreciate that protecting women’s health means providing women access to the full range of reproductive health services and a majority offer abortion coverage.  The Capps Amendment–which means that no federal monies will be used for abortion, but does secure access to the service–is a defensive move primarily intended to ward off hostile Congressional amendments to women’s abortion coverage. The amendment still segregates abortion from the larger field of healthcare, and should not be mistaken as sound policy.  After healthcare reform is enacted, we look forward to a forthright dialogue that puts women’s healthcare needs above politics.”

There is as yet no guarantee that the Capps Amendment–which protects the rights of women to access to abortion care under private insurance even where federal funding subsidies exist for some enrollees–will survive the legislative process and far right groups and legislators continue to mislead on the issue of abortion care in health reform.